Adenopathy
This input is used for staging
Description
Adenopathy is defined as the presence of lymph nodes > 1.5 cm on physical examination (PE) and is part of the staging criteria for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL). For cases diagnosed 1/1/2018 and later, all cases of CLL and SLL will require both the **Lugano classification, which is captured in the AJCC stage group data item, and the five components of the modified Rai staging system, which are captured in Site-Specific Data Items (adenopathy, anemia, lymphocytosis, organomegaly, and thrombocytopenia).** The terms B-cell lymphocytic leukemia/chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are different clinical presentations of the same disease, with both terms coded 9823. Traditionally the lymphoma diagnosis was staged with the Ann Arbor staging system and it is now staged with the Lugano classification. In North America, CLL was staged with the Rai system. See 3955: Derived Rai stage for additional information on the related data items.Rationale
Adenopathy is a prognostic factor required for staging of CLL/SLL in AJCC 8th edition, Chapter 79 *Hodgkin, and Non-Hodgkin Lymphomas*. It is a new data item for cases diagnosed 1/1/2018+.Additional Info
**Source documents:** imaging, physical exam, clinician’s notesNotes
**Note 1:** **Physician Statement** * Physician’s statement regarding the presence of adenopathy (present or absent) takes priority. If a physician’s statement and imaging are both available and in disagreement, go with the physician’s statement * If a physician’s statement is not available, use the definition of adenopathy in the ***Description*** to determine if adenopathy is present or not **Note 2:** **Record information from physical exam only** * This data item is determined from physical exam alone. If a physical exam cannot be used to detect adenopathy due to issues linked to the patient’s obesity, a physician statement of peripheral adenopathy based on a CT scan can be used. * A finding of retroperitoneal or mesenteric adenopathy on CT is not used in determining adenopathy and does not affect the assigned stage **Note 3:** **Rai Stage Criteria** * Rai stage is only applicable for CLL, in which the bone marrow and/or peripheral blood are involved (primary site C421 for bone marrow, see Hematopoietic Manual, Module 3: PH 5, 6). **Note 4:** **Pretreatment results only** * Record this data item based on physical exam, and physician's statement performed at diagnosis (pre-treatment)Coding Guidelines
**1)** **Code 0** when primary Site **is C421** AND there is no evidence of adenopathy * **a.** Physician documentation of Rai Stage 0 **2)** **Code 1** when primary Site **is C421** AND there is evidence of adenopathy * **a.** Physician documentation of Rai Stage I **3)** **Code 5** when primary site **is NOT C421** **4)** **Code 9** when primary site **is C421**, AND there is no mention of adenopathyNAACCR Item
NAACCR #3804Metadata
SSDI| Code | Description |
|---|---|
| 0 | Adenopathy not identified/not present No lymph nodes > 1.5 cm Physician states Rai stage 0 |
| 1 | Adenopathy present Presence of lymph nodes > 1.5 cm Physician states Rai stage I |
| 5 | Not applicable: Primary site is not C421 |
| 9 | Not documented in medical record Adenopathy not assessed or unknown if assessed No Rai stage is documented in the record and there is no documentation of adenopathy Physician states Rai stage II-IV and there is no documentation of adenopathy |